Disorders of the Stomach High Yield Flashcards
Hallmark sign of stomach disorder
Dyspepsia
3 main etiologies for erosive gastritis
- Meds (NSAIDs)
- Alcohol
- Stress
MC clinical manifestation of erosive gastritis
Upper GI Bleeding
Most sensitive method of diagnosing erosive gastritis
EGD
Tx of erosive gastritis
- Remove any causative agent
- Pantoprazole 80mg bolus + 8mg/hr infusion
- EGD within 24hrs
What EGD findings suggest erosive gastritis?
- Erythema
- Red/black mucosal lesions
- Petechial hemorrhages
- Presence of blood vessels
- Absence of rugal folds
Tx of NSAID gastritis
PPIs +/- sucralfate +/- celebrex
Best way to treat/prevent ulcers
PPIs
3 main etiologies for NONerosive gastritis?
- H pylori
- NSAIDs
- Autoimmune gastritis
MC demographic for H pylori infection
Children in crowded areas w/ poor sanitation
What 3 demographics have the most susceptibility to gastric metaplasia?
- Hispanics
- Native Americans
- African Americans
Diagnosis of non-erosive gastritis
EGD w/ biopsy
Workup for pts < 60 w/o uncomplicated dyspepsia
Check for H. pylori via urea breath or fecal antigen.
Criteria to workup pt for non-erosive gastritis with EGD
- > 60 w/ new onset dyspepsia
- Young pts with alarm symptoms
- Failure of initial therapy
- FMHx of gastric cancer
Positive urea breath test
Expired CO2 contains tagged urea isotope
What antibody class is most useful for monitoring H pylori treatment?
IgG
1st therapy for H. pylori eradication
- PPI 20mg BID
- Clarithomycin 500mg BID
- Amoxicillin 1g BID
Please Cure Abdomen
10-14 days
2nd line therapy for H. pylori eradication
- PPI
- Metronidazole 500mg TID
- Tetracycline 500mg QID
- Bismuth 300mg QID
Please Make Tummy Better
What two spots does PUD occur in?
- Duodenum
- Stomach
Age range for stomach PUD
55-70
Age range for duodenal PUD
30-55
What layer is PUD
muscularis mucosa
3 main etiologies for PUD
- H pylori (Duodenum)
- NSAIDs (Stomach)
- Zollinger Ellison
4 PUD risk factors
- NSAIDs
- Age > 60
- Prior PUD or H pylori
- Smoking
Hallmark signs of PUD
- Epigastric, gnawing pain that relieves with eating
- Nocturnal pain that wakes patient
11pm-3am MC time
Diagnosis of PUD
EGD with gastric mucosal biopsy